Provider Demographics
NPI:1750573499
Name:NORMAN, SANDRA (DPT)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:NORMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:BELO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:244 GLEN COVE AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-4171
Mailing Address - Country:US
Mailing Address - Phone:516-801-6650
Mailing Address - Fax:516-801-6653
Practice Address - Street 1:244 GLEN COVE AVE
Practice Address - Street 2:SUITE D
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-4171
Practice Address - Country:US
Practice Address - Phone:516-801-6650
Practice Address - Fax:516-801-6653
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029586225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist